Rapid Range Stacking (RRS) for Particle Beam Therapy

ABSTRACT

According to one general aspect there is a position and tracking module used for a patient position and locating a region of interest, a scanning routine module used for targeting the target voxel within the region of interest by accessing a treatment plan characterization while providing a maximum amount of dose to the target voxel, wherein the scanning routine module determines a maximum amount of dose for the target voxel in all a horizontal index in a single vertical index; and a beam delivery module used for controlling a beaming device that delivers ion particles to the target voxel within the region of interest, wherein the beam delivery module controls a power supply for a horizontal magnet and a vertical magnet by retrieving information from the scanning routine module, wherein the beam delivery module controls a power supply for an accelerator energy selection.

CROSS REFERENCE TO RELATED APPLICATION

N/A

FIELD OF THE INVENTION

The present invention relates to a method for delivering activelyscanned pencil beams combined with dynamic longitudinal scanning for usein particle beam radiation for therapeutic applications. Morespecifically, the present invention relates to the delivery of chargedparticle beams of various species generated from a Rapid CyclingSynchrotron (RCS) or similar device to treat deep-seated cancer andnoncancerous lesions.

BACKGROUND

Modern day radiation therapy (RT) of tumors involved optimizing: targetdose escalation healthy tissue dose reduction and dose fractionation. Itis known in the art that tumors can be eradicated if a sufficient doseis delivered to the tumor volume; however, complications may result fromuse of the necessary effective radiation dose, due to damage to healthytissue which surrounds the tumor, or to other healthy body organslocated close to the tumor. The goal of conformal radiation therapy isto confine the delivered radiation dose to only the tumor volume definedby the margins of the tumor, while minimizing the dose of radiation tosurrounding healthy tissue or adjacent healthy organs.

In conventional radiation therapy with x-rays, intensity modulatingradiation therapy (IMRT) offers an effective treatment for certain typesof tumors and deep-seated lesions when a sufficient radiation dose isdelivered. Cancer cells are often more sensitive to radiation damagethan is surrounding healthy tissue due to inefficient repair. IMRT isdelivered by external source of radiation from either a gamma emitter orlinear accelerator.

The linear accelerator typically has a radiation beam source which isrotated about the patient and directs the radiation beam toward thetumor to be treated. The beam intensity of the radiation beam ispredetermined and optimized for all azimuthal rotation angles. Multileafcollimators, which have multiple leaf, or finger, projections which canbe moved individually into and out of the path of the radiation beam,can be programmed to follow the spatial contour of the tumor as seen bythe radiation beam as it passes through the tumor, or the “beam's eyeview” of the tumor during the rotation of the radiation beam source,which is mounted on a rotatable gantry of the linear accelerator. Themultiple leaves of the multileaf collimator form an outline of the tumorshape as presented by the tumor volume in the direction of the path oftravel of the radiation beam, and thus block the transmission ofradiation to tissue disposed outside the tumor's spatial outline aspresented to the radiation beam, dependent upon the beam's particularazimuthal orientation with respect to the tumor volume.

Tumors that are located deep within the body are generally not amenableto internal forms of treatment. The intrinsic nature of conventionalradiation therapy with x-rays always includes damage to healthy tissueas it enters and exits the tumor volume and conformity is limited to thesuperposition of intersecting beams.

Another form of external beam radiotherapy is intensity modulatedparticle therapy (IMPT), which relies on the ballistic nature ofparticles to produce an inverse depth dose. Particle therapy typicallyutilizes an accelerator to generate high-energy protons to deposit dosein its path to a tumor before stopping at a precise depth know as itsrange. Particles heavier then protons such as carbon ions areadditionally used to take advantage of higher linear energy transfer(LET) in causing more effective biological damage. Specifically, thecharged particles damage the DNA within the cells reducing thereproduction of the cell. The higher mass particles such as carbon ionsproduce more DNA damage per unit of physical dose. This effect ischaracterized as relative biological effectiveness (RBE). Further, thelarger mass associated with heavy ions such as carbon are characterizedby reduced coulombic multiple scattering and range strangling. Thisresults in high spatial precision given reduced lateral beam wideningand sharper distal fall off in the tissue outside the tumor volume. Thegreat advantage of particles either protons or heaver ions is the energylevel stops, and thus, they do not produce an exit dose in the patientresulting in reduction of side effects to surrounding tissue. Allparticles have a variety of energy levels that determines the depth oftreatment of the tumor. Delivered to the tissue is maximum deposition ofthe energy just over the last few millimeters of the particles rangecalled the Bragg Peak. The Bragg Peak is an inverse dose distributionlevel as shown in FIG. 1. The Bragg Peak 1 demonstrates a low level ofenergy, as the particles is entering the human body, and exponentiallyincreases in energy at a specific depth, in which will be the region ofinterest, and thus the high Peak of energy should be within the tumor.This allows minimal damage to the surrounding tissue as compared to theactual tumor.

IMRT and IMPT have positive and negative affects to the patient. IMPTtakes advantage of both biological and physical effects. The first, isfor disease cites that favor the delivery of higher RBE radiation; andsecond, those treatments where the increased precision of particletherapy is used to reduce unwanted side effects by limiting the dose tonormal tissue. In IMPT, the particle distributes high amounts of energyat a specific distance and then has minimal damage to the normal tissue;as opposed to, IMRT has a high level of energy prior to entering intothe tissue and reduces the energy level as it enters through the body.Further, depending on the particle mass IMPT can produce narrower pencilbeam as a pose to conventional IMRT.

Currently, IMPT is delivered with passive double scattering and activescanning techniques. Double passive scattering is the most commontechnique that delivers a broad beam that must be adjusted withpatient-specific hardware that shapes the beam to conform to the shapeof the tumor. Passive double scattering, although still the most widelyused technique, is being replaced with a process called active scanningor more commonly called pencil beam scanning (“PBS”) because of thecorrelation to the optimization algorithm for calculating dose intreatment planning systems (“TPS”). PBS was first introduced by T. Kanaiet al. in 1980 and was developed at the Paul Scherer Institute in themid 1990's. PBS delivers a much more precise beam and has superior 3Ddose conformity as compared to passive double scattering.

In addition, there is the spread of Bragg Peaks as illustrated in FIG.2. The Spread of Bragg Peak (SOBP) is used to demonstrate that particletherapy can distribute evenly throughout a tumor by superimposingmultiple beams at varying energy. However, currently, there are no knownmethods to deliver an entire SOBP dynamically. Further, there arefundamentally many inaccuracies when producing a SOBP sequentially oneenergy per transverse scan.

Therefore, one of ordinary skill in the art would appreciate for a needto precisely balance against the competing objective of destroying asmuch of the cancerous tissue as possible and in reducing exposure tohealthy tissue. Thus, the objective is to deliver a dose sufficient toeradicate or dramatically reduce the tumor while minimizing the impacton surrounding normal.

High-energy particles can be precisely formed into individual beamsdescribed as a pencil beam with spatial and angular dimensions. Chargedparticles such as protons and carbon ions are characterized with inversedepth dose curves that have specific range associated with particlekinetic energy. This unique dosimetric characteristic provides the3^(rd) dimension in producing a uniform dose volume with the ability togenerate particles at specific energies corresponding to precisepenetration depths (z-axis). This 3^(rd) longitudinal dimension, whencombined with the 2 transverse planes (x-y), requires scanning eachpencil beam along 3 axes (x-y-z). Each pencil beam is composed ofindividual pristine Bragg peak that needs to be scanned in 2 orthogonaltransverse (x-y) planes and 1 longitudinal z-axis. The pencil beam isphysically repositioned for each transverse (x-y) position while thelongitudinal z-axis corresponds to the depth of the tumor and requiresthe generation of Bragg peaks of different energies one for each depth.To create a uniform dose with depth, many pristine Bragg peaks arelayered (stacked) one energy level per transverse scan cycle. A spreadout Bragg peak (SOBP) (FIG. 2) is typically generated after manytransverse scan cycles and results in a uniform dose along the tumordepth. A dose distribution can be delivered conformal to a tumor volumeof arbitrary shape using multiple pencil beams. The precision inconforming to the tumor volume is optimized by using pencil beams assmall as possible. Therefore, a large number pencil beams are required.A 3D volume can be decomposed into 3D pixels called voxels. For example,a 1 liter-cubic tumor volume would require over a thousand x-ytransverse positions and 62 energy steps (layers) for carbon ionsresulting in 68 thousand individual voxels.

Therefore, one of ordinary skill in the art would appreciate a method ofdelivering ion radiation to a patient in fewer volumetric steps byreducing the scanning of the x-coordinate and y-coordinate, which causeslatencies between scanning and delivering dose.

SUMMARY OF INVENTION

According to one general aspect there is provided an apparatus fordelivering longitudinal column of dose rapidly to depth extrema of atumor comprising a position and tracking module used for a patientposition and locating a region of interest, wherein the positiontracking module further comprises a registration verification used inconjunction with a patient motion sensor and a tumor motion sensor todetermine the exact location of a target voxel, a scanning routinemodule used for targeting the target voxel within the region of interestby accessing a treatment plan characterization while providing a maximumamount of dose to the target voxel, wherein the scanning routine moduledetermines a maximum amount of dose for the target voxel in all ahorizontal index in a single vertical index; and a beam delivery moduleused for controlling a beaming device that delivers ion particles to thetarget voxel within the region of interest, wherein the beam deliverymodule controls a power supply for a horizontal magnet and a verticalmagnet by retrieving information from the scanning routine module,wherein the beam delivery module controls a power supply for anaccelerator energy selection that is connected to the beaming device,wherein the beam delivery module reads a horizontal strip detector and avertical strip detector. Furthermore, the apparatus for deliveringlongitudinal column of dose rapidly to depth extrema of a tumor, whereinthe position and tracking module further comprises the tumor motionsensor and the patient motion sensor are connected to a timing module,wherein the tumor motion sensor tracks the region of interest.Furthermore, the apparatus for delivering longitudinal column of doserapidly to depth extrema of a tumor, wherein the position and trackingmodule further comprises the timing module is connected to a decisioncontroller that selects a static delivery or a dynamic delivery, whereinthe static delivery contains a static time stamp and uses a treatmentplanning system data used by the scanning routine module, and whereinthe dynamic delivery contains an adaptive treatment planning data usedby the scanning routine module. Furthermore, the apparatus fordelivering longitudinal column of dose rapidly to depth extrema of atumor, wherein the position and tracking module further comprises thetiming module is connected to a beam delivery gate that is used by thebeam delivery module. Furthermore, the apparatus for deliveringlongitudinal column of dose rapidly to depth extrema of a tumor, whereinthe scanning routine module further comprises a database treatmentplanning system that is populate by the beam delivery module and theposition and tracking module. Furthermore, the apparatus for deliveringlongitudinal column of dose rapidly to depth extrema of a tumor, whereinthe scanning routine module retrieves from the database treatmentplanning system a dose prescription, a position location, a positiontime for a specific voxel, and a flag for dose delivery of the region ofinterest. Furthermore, the apparatus for delivering longitudinal columnof dose rapidly to depth extrema of a tumor, wherein the scanningroutine module initiates a delivery beam to the beam delivery module tobegan delivery of the dose prescription and trigger a stop beam.Furthermore, the apparatus for delivering longitudinal column of doserapidly to depth extrema of a tumor, wherein the scanning routine moduledetermines the maximum dose prescription by incrementing the positionlocation of a horizontal index until the horizontal index is reached onthe single vertical index. Furthermore, the apparatus for deliveringlongitudinal column of dose rapidly to depth extrema of a tumor, whereinthe scanning routine module determines the maximum dose prescription byincrementing the single vertical index for the position location untilthe vertical index is reached. Furthermore, the apparatus for deliveringlongitudinal column of dose rapidly to depth extrema of a tumor, whereinthe beam delivery module further comprises a beam control interface thatis connected the horizontal power supply and the vertical power supply.Furthermore, the apparatus for delivering longitudinal column of doserapidly to depth extrema of a tumor, wherein the beam delivery modulefurther comprises a beam control interface that is connected anaccelerator energy selection power source and accelerator beam intensitycontrol power source. Furthermore, the apparatus for deliveringlongitudinal column of dose rapidly to depth extrema of a tumor, whereinthe horizontal power supply is connected to the horizontal magnet and amagnetic field sensor H. Furthermore, the apparatus for deliveringlongitudinal column of dose rapidly to depth extrema of a tumor, whereinthe vertical power supply is connected to the vertical magnet and amagnetic field sensor V. Furthermore, the apparatus for deliveringlongitudinal column of dose rapidly to depth extrema of a tumor, whereinthe an accelerator energy selection power source is connected to thebeam device and a beam fluence sensor. Furthermore, the apparatus fordelivering longitudinal column of dose rapidly to depth extrema of atumor, wherein the accelerator beam intensity control power source isconnected to a intensity modulation device, a beam fluence sensor septumand a beam fluence sensor nozzle.

In another general aspect there is provided an method for deliveringlongitudinal column of dose rapidly to depth extrema of a tumor bylocating a region of interest of a patient by a position tracking aregistration verification used in conjunction with a patient motionsensor and a tumor motion sensor to determine the exact location of atarget voxel, targeting the target voxel with the region of interest byaccessing a treatment plan characterization while providing a maximumamount of dose to the target voxel, wherein a scanning routine moduledetermines a maximum amount of dose for the target voxel in all ahorizontal index in a single vertical index, and controlling a powersupply for a horizontal magnet and a vertical magnet by retrievinginformation from the scanning routine module, further comprisingcontrolling a power supply for an accelerator energy selection that isconnected to a beaming device, wherein a beam delivery module reads ahorizontal strip detector and a vertical strip detector. Further, themethod for delivering longitudinal column of dose rapidly to depthextrema of a tumor also includes by tracking the region of interest byuse of a tumor motion sensor. Furthermore, the method for deliveringlongitudinal column of dose rapidly to depth extrema of a tumor alsoincludes by selecting a static delivery or a dynamic delivery to thepatient by operating a GUI. Furthermore, the method for deliveringlongitudinal column of dose rapidly to depth extrema of a tumor alsoincludes by populating a database treatment planning system by a beamdelivery module and a position and tracking module, delivering a doseprescription to the beam delivery module, measuring a delivery dose fromthe beam delivery module, incrementing a horizontal index as many timesas needed within the region of interest and within the single verticalindex, and incrementing the single vertical index as many times asneeded with the region of interest.

DESCRIPTION OF THE DRAWINGS

FIG. 1 is a prior art illustration of a sample Bragg Peak for a protonreleased from a cyclotron or synchrotron.

FIG. 2 is prior art illustration of a spread of Bragg Peak (SOBP) for aplurality of protons released from a cyclotron or synchrotron.

FIG. 3 is an exemplary illustration of the rapid range stacking (RRS)technique for radiating a region of interest.

FIG. 4 is a flow chart illustrating the method of operating the rapidrange stacking technique.

FIG. 5 is an exemplary illustration of the position and tracking steps.

FIG. 6 is an exemplary illustration of the scanning routine of the RRStechnique.

FIG. 7 is an exemplary illustration of the beam delivery process of theRRS technique.

DETAILED DESCRIPTION

The invention generally relates to a device that is used to treatpatients using rapid cycling regarding particle therapy.

The following detailed description is provided to assist the reader ingaining a comprehensive understanding of the methods, apparatuses,and/or systems described herein. Accordingly, various changes,modifications, and equivalents of the systems, apparatuses and/ormethods described herein will be suggested to those of ordinary skill inthe art. Also, descriptions of well-known functions and constructionsmay be omitted for increased clarity and conciseness.

In the Summary of the Invention above and in the Detailed Description ofthe Invention, and the claims below, and in the accompanying drawings,reference is made to particular features (including method steps) of theinvention. It is to be understood that the disclosure of the inventionin this specification includes all possible combinations of suchparticular features. For example, where a particular feature isdisclosed in the context of a particular aspect or embodiment of theinvention, or a particular claim, that feature can also be used, to theextent possible, in combination with and/or in the context of otherparticular aspects and embodiments of the invention, and in theinvention generally.

Rapid Range Stacking (RRS) is a pencil beam scanning (PBS) method thatdelivers an entire spread out Bragg peak (SOBP) in order to fill thelongitudinal extent of a tumor volume with radiation quickly prior torepositioning the pencil beam in the transverse plane. This enables the3D tumor volume to be filled with radiation in a single transversescanning cycle. A SOBP is the superposition of multiple Bragg peaks witheach composed of particles at the specified energy required to penetratethe tumor to the longitudinal depth referred to as range. This inventionis the method of rapidly stacking multiple pencil beams with particleswith range varying from distal to proximal extent of the tumor.

FIG. 3 is an exemplary illustration showing how the charge particles aredeflected by horizontal magnet 67 and vertical magnet 73. Initially, theparticle beam 4 is projected through a beaming (beam generating) deviceand first goes through the horizontal magnet 67. The horizontal magnets67 are used to control the X coordinate position of the particle 4.Thereafter, the particle 5 travels through the vertical magnets 73 thatare used to control the Y coordinate position of the particle. The Zcoordinate position is the direction in which the particle is beingprojected from the beaming (beam generating) device into the patient.Specifically, by controlling the strength of each vertical magnet 73 andhorizontal magnets 67 the particle 7 is being directed to the tumor siteby using the magnetic flux of the magnets. Further, when looking at thechange in energy, the entire stack 7 is being irradiated in the tumorrapidly.

FIG. 4 is an exemplary block diagram of the treatment routine used bythe following system. Initially, you begin with patient positioning andtracking 11 then you moved to scanning routine 13, which has multipleoptions to return back to patient position and tracking 11 or move tobeam delivery 15. The scanning routine 13 is used to constantly changethe magnetic flux in relation to the tumor position. The beam delivery15 is used to deliver a wide range of rapid cycling particles to aspecific region in the tumor. Beam delivery 15, overall, controls theoutput of the particles in relation to and with instructions fromscanning routine 13. After, patient position and tracking 11, scanroutine 13, and beam delivery 15 are complete then the treatment cyclehas ended.

FIG. 5 is an exemplary block diagram of the patient position andtracking 11. The patient positioning and tracking are first determinedby taking the relative location of the patient, which is in patientposition 17. In the patient position, you determine the region ofinterest of the tumor. Then, in registration verification 19, you areverifying the internal target of the patient and are comparing it to thePET, CT, MRI images. Then, you would re-position the patient to correctfor any displacement for the patient. The registration verification 19is used as an improved method for correcting any undesired regions ofinterest for treatment. When dealing with the human body, certainregions of the human body contain constant movement such as breathing.When trying to determine the region of interest in a lung, there is apatient motion sensor 21. Patient motion sensor 21 is used to determinethe contours of the region of interest outside the patient. This methodmay be done or determined by taking video or a series of sliced imagesover a period of time. The tumor motion sensor 23 takes the contours ofthe tumor that is within the patient. The tumor motion sensor 23 isdetermined by using x-ray beams that take the rhythm of the movement ofthe tumor and therefore fiducialize the tumor with coordinate marks thatare then used to determine the location with respect to time of thetumor. The image sets that are taken in tumor motion sensor 23 arecorrelated to the image sets that are located in the registrationverification 19 of the patient. Therefore, after correlation, tumormotion sensor will provide an X-coordinate position, Y-coordinateposition, Z-coordinate position, time-position for a specific regionwithin the tumor. The time module 27 takes all this information forconfirmation and then delivers to the beam delivery gate 35. Timingmodule 27 is then connected to a decision controller 28, which ismanually controlled by a GUI user to choose one of 2 tracking modeseither utilizes static delivery or a dynamic delivery, wherein a staticdelivery is operated by a static timing for TPS data 25 and a dynamicdelivery is operated by an adaptive TPS data 29. When taking the statictiming for TPS data 25, the static time stamp 25 takes the specific timeand applies a certain amount of dose at that position. The static timingfor TPS data 25 contains a library of information regarding time andspecific positions of the tumor. Basically, static time stamp 25 iswaiting for the tumor to be in a specific position relative to the time,which then provides information to beam delivery gate 35. The benefit ofstatic timing for TPS data 25 is that you are able to irradiate/providedose to a region of interest at a specific time. For example, if a tumoris moving within a certain constant frequency and that frequency ofmovement is a +5 cm/−5 cm indicating a total of 10 cm movement, by usingthe patient motion sensor 21 and tumor motion sensor 23, static timestamp TPS data 25 will indicate its precise time within the frequencyand location of the tumor to be radiated, therefore notirradiating/providing dose areas outside the region of interest. Theverification is done in the TPS data 31, which then determines if thereis timing information for the region of interest. This is different fromthe dynamic delivery by the adaptive TPS data 29, the adaptive TPS data29, when initiated, takes constant information from patient motionsensor 21 and tumor motion sensor 23 and uses this information by takingdata points Epromixal (t), Edistial(t), Xo(t), Xn(t), Yo(t), and Ym(t).Adaptive TPS data 29 is used to provide rapid dose at multiple frequencypositions relative to time. The adaptive TPS data 29 unlike the statictime stamp TPS data 25 has multiple information points of time andposition regarding the region of interest, while the static time stampTPS data 25 only has one specific position relative to time for theregion of interest. Thus the adaptive TPS data 29 allows for multipledelivery of dose of a moving region of interest in a constant frequency.For an example, if a tumor is located near the lung and there issufficient patient motion sensor 21 and tumor motion sensor 23, thatinformation can be used to verify specific points of the region ofinterest and provide multiple dose delivery of the region of interestwithin a single frequency, thus, providing quicker dose treatment to thepatient. Further, the adaptive TPS data 29, also, indicates that if theregion of interest were to move, the system will compensate by providinga dose at a close distance or to a further distance relative to thetumor. Adaptive treatment requires various prescriptions correspondingto different tumor positions specified in the energy deposition arrayEnergy (x, dx, y, dy, z, dz, particle, t). This array specifies theprescribed dose for the given particles at each position and step intime. The information is then sent to the scanning routine 33.

Next, time module 27 sends information to the beam delivery gate 35. Thebeam delivery gate 35 is used to communicate dose information at aspecific time. The beam delivery gate 35 is used to synchronize thedelivery of beam with the moment in time and communicates to the beamdelivery when to turn the beam on or off.

FIG. 6 is an exemplary block diagram of the scanning routine 13 of FIG.4. The scanning routine 13 is to verify that rapidly stacking multiplepencil beams are delivered to a specific coordinate prior to moving toanother location. The lookup TPS data 39 is a database that contains allverified points of the region of interest. The lookup TPS data 39contains the dose prescription 43 or the energy intensity that will beused for each specific voxel. The system takes this patient specificinformation, and determines the amount of dose each voxel will receiveand sets parameters for the beam delivery. The information contains theamount of energy and intensity that is used for each voxel. Then, thedose prescription 43 initiates deliver beam 45, which then selects aspecific energy level. This energy level is very important to determine,since in ion therapy the particles have an inverse peak energy point,the specific distance of the tumor regarding the rise in energydelivery. The delivery beam 45 can be initiated by starting with highenergy or low energy level, which means that the treatment to the regionof interest is furthest from the beam treatment or closest to the beamtreatment. The delivery beam 45 also indicates the energy for thehorizontal and vertical magnets used in beam delivery 41. The beamenergy is continuously indexed between extrema as the system measuresthe dose being delivered 47 from the beam generating device. Themeasured dose 47 is used by the delivery system to control the intensityat each energy to generate a uniform SOBP that is delivered to thepatient. Further, measured dose at beam generating device (example: atextraction septum) 47 is used to determine the maximum integrated dosefor that specific voxel. The measured dose at extraction septum 47 takesdelivery dose information and stores it for recordation purposes. Next,command loop determines if the measured dose is equal/reached the amountof dose required for that voxel 49. If the measured dose has not reachedthe dose prescription, the command operator continues beam delivery 45and then receives measured dose spectrum 47 from beam delivery to yetagain determine if measured dose is equal to prescription dose for thatspecific voxel 49. When, measured dose is equal to prescription dose,the system stops beam 51. Afterwards, the system then increments thehorizontal Index 53 and returns to lookup TPS data 39. By incriminatinghorizontal index by +1, the system has to look up all treatment planningsystem data for that new specific voxel and then again treat thatspecific voxel with the following steps in dose prescription 43, sendsthe information to beam delivery 45, measures dose 47 from beingdelivery 41 and determines that dose prescription equals to measureddose and thereafter increments horizontal Index until horizontal Indexis equal to i=0 56. Thereafter, the system then increments verticalIndex by +1, and yet again, returns to lookup TPS data 39 to initiateall the steps for delivering dose to each voxel. This process rapidlyscanning energy to deliver a uniform SOBP in a single transverse X-Yscan has the efficiency of reducing latent scanning periods used todeliver a dose. The system delivers the dose as precisely as possiblethrough the generation of a uniform spread out Bragg peak in a singlebeam generation cycle. Instead of delivery individual dose in a singleX-Y plain, you are delivering the dose to a stack of voxels in thez-coordinate rapidly. When, all be vertical indexes have beenincremented, and that j=0 61, the system has scanned and delivered thedose in stacks to the region of interest.

FIG. 7 is an exemplary block diagram of the scanning routine 15 of FIG.4. Beam delivery is controlled by beam control interface 63. Beamcontrol interface 63 also has incremental energy distributioninformation that is received from scanning routine 13. The main purposeof the beam control interface 63 is to allow a universal control modulethat operates the delivery of dose while taking information from patientposition tracking 11 and scanning routine 13. By creating one centralcontrol interface, such as beam control interface 63, the systemoperates in a static manner, which means that all major controlfunctions are operated in a single control module when delivering doseto the patient therefore reducing motor control interference andprocessing latency. Further, beam delivery 15 controls all parametersthat are referred to by the dose prescription 43 within scanning routine13. The scanning routine 13 provides command information to the beamcontrol interface 63, which then controls the increment energy 64.Depending upon the information provided from scanning routine 13, beamcontrol interface 63 initially instructs the horizontal scanning powersupply 65. The horizontal scanning power supply 65 is used to controlthe polarity and intensity of the horizontal magnet 67 by controllingelectric current that affects the magnetic flux which then changes themagnetic field sensor 69. The magnetic fields sensor 69 is used toverified beam deflection and beam position. The magnetic field sensor 69provides verification data to the beam control interface 63 to increaseor decrease horizontal scanning power supply 65. When the magnetic fieldsensor 69 provides the correct horizontal position, beam controlinterface 63 thereafter initiates accelerator energy synchronization orselection power source 77. The accelerator energy selection power source77 is used to control the energy of the delivery and beam device 79 isused to synchronize the beam energy index between extrema. The beamenergy index is specified by the Bragg peak width from minimum tomaximum penetration depth. The beam device 79 synchronizes the intensitymodulation device 85 before the particle beam is delivered to thetreatment device. The particle beam is measured with beam fluent sensor81 located in an energy sensitive position; thereafter, the particlebeam travels from the treatment device to the patient's region ofinterest. The beam fluent sensor 81 is used to measure the amount ofradiation as energy is changing and is recorded into the beam controlinterface 63. The beam control interface 63 will then provide thisinformation to scanning routine 13 to determine if that specific voxelhas reached its prescription dose level. When the voxel has received itsprescription dose level as verified in scanning routine 13, beam controlinterface 63 then, again in a nested loop, changes horizontal scanningpower supply 65 which then controls horizontal magnet 67 which then isread by magnet fields sensor 69 that is directed to the next position inthe horizontal Index within the region of interest for treatment. Whenthe scanning routine 13 has indicated that all horizontal voxel's havebeen treated, beam control interface 63 then will instruct verticalscanning power supply 71 which then controls vertical magnet 73, whichthen is read by magnet fields sensor 75. Once the vertical magnet 73 isset in a precise field strength, the beam control interface will thenoperate the horizontal scanning power supply 65, horizontal magnet 67and will read magnetic field sensor 69 which will then operateaccelerator energy selection source 77 to deliver the dose in beamdevice 79 and verify this information in beam fluent sensor 81. Thebenefit of this nested loop is that a full column of dose is deliveredfilling multiple voxels with multiple energy levels rapidly. Theintensity of each energy level is controlled power source 77 andincremented for each energy level. Traditional pencil beam scanningdelivers 2D transverse slices of dose to the tumor one energy levelpiecewise layer by layer. The beam control interface 63 can also operateaccelerator beam intensity control power source 83 which is used tocontrol the intensity of the delivered intensity modulation device 85 asthe beam energy is continuously indexed between extrema. This intensitycontrol is specified to produce a uniform SOBP for each penetrationdepth. The intensity modulation device 85 delivers the particle beam tothe treatment device and the particle is measured in treatment devicewith beam fluent sensor 81; thereafter, the particle beam travels fromthe treatment device which contains fluence sensor 87 to the patient'sregion of interest. The beam fluent sensor 87 is used to measure theamount of radiation the patient has received and is recorded into thebeam control interface 63. The SOBP is generated by the summation ofintensity modulated Bragg peaks from Z₀ to Z_(n) where the index step isspecified by the Bragg width at each energy.

SOBP(Z ₀ :Z _(n))=SUM(C ₀ *Z ₀ :C _(n) *Z _(n))

The intensity is modulated from C₀ to C_(n) where the maximum intensityis associated with the beam with the highest energy within the SOBP.Horizontal strip detector 91 provides feedback to beam control interface63 to verify correct horizontal scan position. Vertical strip detector93 additionally provides feedback to beam control interface 63 to verifycorrect vertical scan position.

All the features disclosed in this specification (including anyaccompanying claims, abstract, and drawings) may be replaced byalternative features serving the same, equivalent or similar purpose,unless expressly stated otherwise. Thus, unless expressly statedotherwise, each feature disclosed is one example only of a genericseries of equivalent or similar features.

1. An apparatus for delivering longitudinal column of dose rapidly todepth extrema of a tumor comprising: a position and tracking module usedfor a patient position and locating a region of interest, wherein saidposition tracking module further comprises a registration verificationused in conjunction with a patient motion sensor and a tumor motionsensor to determine an exact location of a target voxel; a scanningroutine module used for targeting said target voxel within said regionof interest by accessing a treatment plan characterization whileproviding a maximum dose prescription to said target voxel, wherein saidscanning routine module determines a maximum amount of dose for everysaid target voxel in a plurality of horizontal index within a singlevertical index; and a beam delivery module used for controlling abeaming device that delivers ion particles to said target voxel withinsaid region of interest, wherein said beam delivery module controls apower supply for a horizontal magnet and a vertical magnet by retrievinginformation from said scanning routine module, wherein said beamdelivery module controls a power supply for an accelerator energyselection that is connected to said beaming device, wherein said beamdelivery module reads a horizontal strip detector and a vertical stripdetector.
 2. An apparatus of claim 1 for delivering longitudinal columnof dose rapidly to depth extrema of a tumor, wherein said position andtracking module further comprises: said tumor motion sensor and saidpatient motion sensor are connected to a timing module, wherein saidtumor motion sensor tracks said region of interest.
 3. An apparatus ofclaim 2 for delivering longitudinal column of dose rapidly to depthextrema of a tumor, wherein said position and tracking module furthercomprises: said timing module is connected to a decision controller thatselects a static delivery or a dynamic delivery, wherein said staticdelivery contains a static time stamp and uses a treatment planningsystem data used by said scanning routine module, and wherein saiddynamic delivery contains an adaptive treatment planning data used bysaid scanning routine module.
 4. An apparatus of claim 2 for deliveringlongitudinal column of dose rapidly to depth extrema of a tumor, whereinsaid position and tracking module further comprises: said timing moduleis connected to a beam delivery gate that is used by said beam deliverymodule.
 5. An apparatus of claim 1 for delivering longitudinal column ofdose rapidly to depth extrema of a tumor, wherein said scanning routinemodule further comprises: a database treatment planning system that ispopulate by said beam delivery module and said position and trackingmodule.
 6. An apparatus of claim 5 for delivering longitudinal column ofdose rapidly to depth extrema of a tumor, wherein said scanning routinemodule retrieves from said database treatment planning system a doseprescription, a position location, a position time for a specific voxel,and a flag for dose delivery of said region of interest.
 7. An apparatusof claim 6 for delivering longitudinal column of dose rapidly to depthextrema of a tumor, wherein said scanning routine module initiates adelivery beam to said beam delivery module to began delivery of saiddose prescription and trigger a stop beam.
 8. An apparatus of claim 7for delivering longitudinal column of dose rapidly to depth extrema of atumor, wherein said scanning routine module determines said maximum doseprescription by incrementing said position location of every said targetvoxel within said horizontal index until every said horizontal index isreached within said single vertical index.
 9. An apparatus of claim 8for delivering longitudinal column of dose rapidly to depth extrema of atumor, wherein said scanning routine module determines said maximum doseprescription by incrementing said single vertical index for saidposition location until said vertical index is reached.
 10. An apparatusof claim 1 for delivering longitudinal column of dose rapidly to depthextrema of a tumor, wherein said beam delivery module further comprises:a beam control interface that is connected a horizontal power supply anda vertical power supply.
 11. An apparatus of claim 1 for deliveringlongitudinal column of dose rapidly to depth extrema of a tumor, whereinsaid beam delivery module further comprises: a beam control interfacethat is connected an accelerator energy selection power source and anaccelerator beam intensity control power source.
 12. An apparatus ofclaim 10 for delivering longitudinal column of dose rapidly to depthextrema of a tumor, wherein said horizontal power supply is connected tosaid horizontal magnet and a magnetic field sensor H.
 13. An apparatusof claim 10 for delivering longitudinal column of dose rapidly to depthextrema of a tumor, wherein said vertical power supply is connected tosaid vertical magnet and a magnetic field sensor V.
 14. An apparatus ofclaim 11 for delivering longitudinal column of dose rapidly to depthextrema of a tumor, wherein said accelerator energy selection powersource is connected to said beam device and a beam fluence sensor. 15.An apparatus of claim 11 for delivering longitudinal column of doserapidly to depth extrema of a tumor, wherein said accelerator beamintensity control power source is connected to a intensity modulationdevice, a beam fluence sensor septum and a beam fluence sensor nozzle.16. An method for delivering longitudinal column of dose rapidly todepth extrema of a tumor comprising: locating a region of interest of apatient by a position tracking a registration verification used inconjunction with a patient motion sensor and a tumor motion sensor todetermine an exact location of a target voxel; targeting said targetvoxel with said region of interest by accessing a treatment plancharacterization while providing a maximum amount of dose to said targetvoxel, wherein a scanning routine module determines a maximum amount ofdose for said target voxel in all a horizontal index in a singlevertical index; and controlling a power supply for a horizontal magnetand a vertical magnet by retrieving information from said scanningroutine module, further comprising controlling a power supply for anaccelerator energy selection that is connected to a beaming device,wherein a beam delivery module reads a horizontal strip detector and avertical strip detector.
 17. An method of claim 16 for deliveringlongitudinal column of dose rapidly to depth extrema of a tumorcomprising: tracking said region of interest by use of a tumor motionsensor.
 18. An method of claim 16 for delivering longitudinal column ofdose rapidly to depth extrema of a tumor comprising: selecting a staticdelivery or a dynamic delivery to said patient by operating a GUI. 19.An method of claim 16 for delivering longitudinal column of dose rapidlyto depth extrema of a tumor comprising: populating a database treatmentplanning system by a beam delivery module and a position and trackingmodule; delivering a dose prescription to said beam delivery module;measuring a delivery dose from said beam delivery module; incrementing ahorizontal index as many times as needed within said region of interestand within said single vertical index; and incrementing said singlevertical index as many times as needed with said region of interest.